Study on the application of epinephrine hydrochloride in senile ptosis surgery
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摘要: 目的 探索盐酸肾上腺素与利多卡因混合麻醉在老年性上睑下垂手术中的应用。 方法 采用随机对照临床研究方法，选取2016年1月至6月陆军军医大学第三附属医院眼科收治的老年性上睑下垂患者90例（180眼），随机分为实验组和对照组，实验组采用混合有盐酸肾上腺素的利多卡因进行皮下浸润麻醉，对照组采用利多卡因药物进行皮下浸润麻醉。观察两组患者术中心率、血压、出血量、视野清晰度、手术时间、术后切口状态、角膜和愈后等情况。 结果 ①老年性上睑下垂患者的收缩压：实验组明显高于对照组（P<0.05）；舒张压和心率两组差异无统计学意义（P>0.05）；②老年性上睑下垂患者的手术时间、麻醉时间、出血量、视野清晰度、眼睑淤血、术后1周伤口愈合情况实验组优于对照组（P<0.05）；③患者术后切口敷料有无渗血及渗液、角膜情况，实验组与对照组无明显差异（P>0.05）。 结论 混合盐酸肾上腺素的麻醉对患者舒张压、心率影响较小，可减少老年性上睑下垂患者术中出血量、保证术中视野的清晰度，能有效减轻术后眼睑淤血，利于术后伤口恢复。Abstract: Objective To explore the application of mixed anesthesia with epinephrine hydrochloride and lidocaine in senile ptosis surgery. Methods 90 senile ptosis cases (180 eyes) treated from January 2016 to June 2016 were randomly divided into experimental group and control group. Subcutaneous infiltration anesthesia with lidocaine and epinephrine hydrochloride was used in the experimental group, while the control group received lidocaine only. The heart rate, blood pressure, blood loss, visual field definition, operation time, incision state, cornea and recovery rate of the two groups were observed. Results ① The systolic blood pressure of the patients in the experimental group was significantly higher than that of the control group (P<0.05). There was no significant difference between two groups in diastolic blood pressure and heart rate (P>0.05). ② The experimental group achieved better results than the control group in operation time, anesthesia time, amount of bleeding, visual field clarity, eyelid congestion and wound healing (P<0.05); ③ There was no significant difference (P> 0.05) between two groups in incisional dressing bleeding, fluid seepage and cornea status. Conclusion The mixed anesthesia of epinephrine hydrochloride and lidocaine had little effect on the patients' diastolic blood pressure and heart rate. It reduced the blood loss during operation and the postoperative eyelid congestion. The clarity of intraoperative vision and recovery time were also improved with the mixed anesthesia.
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Key words:
- adrenaline /
- ptosis /
- mixed anesthesia
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